Rodent/Rabbit/Small Animal Admission Form

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Rodent/Rabbit/Small Animal Admission Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.

Owner Name: *

First

Last

Pet Details:

Pet Name: *

Species/Breed/Variety:

Sex:

Male
Female
Unknown

Identification( show number):

Tattoo:

Microchip:

Band:

Animal is a:

House Pet
School Pet
Breeder

Females only:

How many litters?

Source of pet:

Store
Exotic Animal Show
Private Party
Breeder
Other

Other

Please upload a photo of pet’s habitats

Click or drag a file to this area to upload.

Date acquired:

Current Age:

Housing:

Cage type and Size

Cage mates? If so, how many and what sex?

Enclosure substrate covering bottom of cage (ex. Carefresh, aspen shavings, paper pellets)

Does pet have access to entire house?

Yard?

Fenced area?

Exercise Pen?

Temp in enclosure:

Any additional heat/cooling devices? (chinchillers, marble slabs, heat lamps?)

Enclosure substrate covering bottom of cage:

Decorations/toys/hides in enclosure:

Diet/Feeding:

Water source?

Bottle
Bowl

Basic primary food and brand(s)

How often are these offered?

What vegetables/fruits are given? How often?

Other foods/treats offered?

Any supplements? If so, how often and what kind?

Care:

Any shampoos/sprays used?

Do you bathe/brush/clean ears, clip nails on your pet? If so, how often?

Is your pet litter trained? If so, what substrate?

(GERBILS, CHINCHILLAS, HAMSTERS ONLY) Does your pet use a dust bath? If so how often? Does it stay in the cage or do you do it outside of the cage?

History:

Previous vet?

Any major medical history?

Adverse reactions to medication?

(FERRETS AND RABBITS ONLY) Has your pet had vaccines before? Is pet up to date on vaccines?

Ready To Visit?

BOOK AN APPOINTMENT

Pinnacle Animal Hospital proudly serves the communities of Arden, Asheville, Fletcher, Fairview, Hendersonville, Candler, and Black Mountain, NC.

Book Appointment

Have Any Questions?

Get in touch! We look forward to hearing from you.

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Location

200 Julian Lane
Suite 240
Arden, NC 28704

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Contact Information

Phone: (828) 676-2332
Email: info@pinnacleanimalhospital.com

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Hours

Monday-Friday: 8 AM – 6 PM
Saturday: We are open the 1st and 3rd Saturday of each month from 8 AM – 12 PM
Sunday: Closed

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Email *

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How can we help you? *

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